Provider Demographics
NPI:1164714648
Name:MCTASNEY, JEANINE GELLER
Entity Type:Individual
Prefix:
First Name:JEANINE
Middle Name:GELLER
Last Name:MCTASNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1436 2ND ST UNIT 144
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-5003
Mailing Address - Country:US
Mailing Address - Phone:505-204-6500
Mailing Address - Fax:
Practice Address - Street 1:433 SOSCOL AVE STE B161
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-4037
Practice Address - Country:US
Practice Address - Phone:505-204-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty